MyAccess Sign In

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess Profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

For the most part, in the developed world, neonatal jaundice occurs without significant morbidity and/or mortality due to early diagnosis and treatment.1 However, most literature from low-middle-income countries (LMICs) suggests that it accounts for significant morbidity and mortality in contrast to that in the United States and developed world (Table 13-1).2–18 For example, based on limited population-based data available worldwide, severe neonatal jaundice is about 100-fold greater in Nigeria than in the developed world. In one of the few population-based studies from the developed world, Ebbesen et al.17 from Denmark reported that 24/100,000 neonates met exchange blood transfusion (exchange transfusion [ET]) criteria, while 9/100,000 developed acute bilirubin encephalopathy (ABE), in comparison to results from the only population-based study in Nigeria, in which Olusanya et al. reported 1860/100,000 infants had an EBT.19 Based on the limited data available, ABE is at least as common as tetanus as a cause of neonatal deaths in Nigeria, Kenya, and Pakistan,11,13,20–23 and likely in most LMICs often ranking as one of the top five causes of neonatal death.8,11,13,24

The available literature indicates that, in LMICs, a significant proportion of survivors of severe neonatal hyperbilirubinemia have signs of chronic bilirubin encephalopathy or kernicterus1 (e.g., cerebral palsy, deafness, and language processing disorders (Table 13-2).25–34 Children with disabilities are a tremendous burden on families in LMICs, where resources are already stretched thin; such children are often left with few or no options for improved quality of life35,36 and experience ...